tv Capital News Today CSPAN February 8, 2010 11:00pm-2:00am EST
one lieutenant. in the house -- in the senate, excuse me, what terri reid, the majority leader, dick durbin -- watch harry reid, dick durbin, chuck schumer. look at this group of senators to see what they are saying and doing and you might be able to read the tea leaves. host: what should we be watching across the country where jobs is the big issue? guest: alabama look at the states that are hurting the most. harry reid is going to pay -- i think you have to look at the states that are hurting the most. harry reid is going to play a big role pretty faces poll numbers that show him down double digits to republican candidates that have not been even heard of. that is terrible for him as the faces reelection.
if jobs keep coming back to nevada and people keep going to nevada, he has a shot -- he may win re-election. host: thank you for your time. >> john murtha of pennsylvania and died today at the age of 77 after complications from gallbladder surgery. president obama released a statement that said that john murtha's passion for service was born during his decorated career in the united states marine corps and he earned the distinction of being the first combat war veteran earned -- elected to congress.
>> the pennsylvania delegation, at least the democrats would tend to gather in sort of a of a corner of the house. if you are facing the speaker's podium, it is on the left side as far back in the corner as you can get. he would take that course seat and the pennsylvania -- pennsylvania delegation would gather around him, exchanging stories and talking business. someone would come up who was looking for help for his or her district for defense contractor and purposes. he was the only member who would stay in the same place. >> you talk about defense. he was the first vietnam combat
veteran to serve in congress. how did that and for his work? -- inform his work? >> it made him a real defender of the military, even when the military did not want them. he was legendary for fighting to fund projects. a lotbmf them were in his home district. it sometimes went against an america -- administrations that wanted to cut funding. there are always folks who -- generals who would like to see more projects and funding for weapons and things. that informed his time there and his coming out against the iraq war a few years ago. he was one of the first major figures in congress to speak out against the war. at the time, it was attributed to being on the ground in vietnam as a marine and seen how
difficult that was and what is in that first hand. he saw some of the same things going on in iraq, well before many establishment figures publicly said so. >> some critics called him the king of pork barrel. what kind of spending did he bring back to his district and how did he respond to critics? >> he was unapologetic and basically said -- i saw him speak back over the recess in august. he spoke to a small group of folks in pennsylvania. he had brought some projects and said, i am down in washington, that is what i'm there for. and there to help my district and i do not care what people say about the remarks. that is what i was sent there to do. in the 12th district, they loved him. he got reelected and the general election by 55% every time because he was such a source
economically for his district. he had no problem doing it. >> several brushes with scandal over the years. was he ever charged with anything or damaged at all politically? >> some of the stop domestic and politically somewhat, but he was never charged. -- stuff damaged him politically somewhat, but he was never charged. he was never pinned it down in any of those. he had a hint of scandal around him for many years, but nothing was proven and it did not hurt him. but mcdaniel loyal of the pittsburgh post-gazette, thank you for being with us. -- >> daniel malloy of the
pittsburgh post-gazette, thank you for being with us. >> ambassador bolton, and kathleen sebelius in about 40 minutes. the head of the food and drug administration is after that. later, a discussion of climate change from the world economic forum. >> on "washington journal." questions about the jobs bill working its way through the senate. we hear from mark moyar the war in afghanistan. a presidential historian discusses the updated version of a book about grant's tomb, a tour a presidential grave sites. "washington journal"is like
every day on c-span at 7:00 a.m. eastern. >> it is the only collection painted by one artist of presidents. it is now on display at purdue university in west lafayette, indiana, through february 21, looking at the lives of the men who have held the office through paintings, and audio recordings, it is sponsored by c-span and the white house and historical association. you can see the collection at least an's web site -- at c- span's website. >> john bolton talks about the obama administration's foreign- policy. he spoke at a conference hosted by the hudson institute for about 45 minutes. >> i appreciate you being here to support this. i want to talk about the situation we find ourselves and
concerning our national security. let's look at it from the perspective that foreign policy issues do not take place in a vacuum. the are the result of decisions with specific -- they are the result that specific individuals may. i did not leave and determinism. it is important that we understand -- i do not believe in determinism. it is important to understand what is going on under the obama administration. we are about one-quarter through it he said optimistically. i think it's important to understand that many things the president believes are representative of large segments of the american population and representative of what is probably the predominant view in europe,
though not a popular view necessarily. it is widely shared around the world. >> i want to talk about the mindset that governs the administration's formulation of foreign policy and about sums up as examples of how it plays out and how it has played out during the first year and the next three years. we will try to explain why the performance today and likely performance coming has been so detrimental to our national security. first, i do not think the president really cares about foreign policy or national security. that missing are remarkable
statement, but i think his history demonstrates that it has never been a major part of his career, even though lee has lived overseas as a child. -- even though he had lived overseas as a child. his record in politics, which is the only record the past, has been focused exclusively on domestic policy. i think it is clear from the first year that he would rather spend time restructuring health care and financial systems, our energy and environmental regulations. you get a point. -- you get the point. that is what he wants to do. while he will deal with foreign policy when he asked to, it is more of a distraction than a priority. it is a remarkable development for an american president. closely related to that is that he does not believe we live in a threatening world. he has bought wholesale the
notion that the end of the cold war means that there is no current existential threat to the united states, nor is it likely that one will develop. he does not see the threat that many others do from terrorism, proliferation, from other countries in the world that do not necessarily have our best interest at heart. he does not see them as threatening and is not concerned about the decline of american power in the world. some people think that he thinks our power is ill-cotton and that we do not deserve it. -- ill-gotten and that we do not deserve it, that we took advantage of the circumstances of the past century. if we come down a peg or two, no big deal. you can see this combination of a president who does not care much about politics -- foreign policy and does not begin to think the world is terribly threatening -- it is going to be focused on issues that
amount to threats to our country. that is actually, when you think about that, a formula for isolationism. unlike the classic american -- isolationist, he gives new meaning to the phrase, " multilateralism." that ties and as well with the view that he holds, and he is unique in that regard, too. i call them our first post- american president. i use that term very advisedly. i do not say un-american or anti-american. want to be very clear about that. he is post-american. he is above all that patriotism
stuff. that respect, he is similar to the european of the tests that -- a leak tests -- elitists. he takes pride in saying that he views himself as a citizen of the world. that is not just a throwaway praise for him. it reflects a deep belief. when you put all that together, i think you can see why so many of the president's policies overall and those particularly we will see coming in the next three years constitute a clear decision on his part to participate -- and to have the united states participate in the process of global governance.
there was a time when people talked about world federalism. some people actually talk about world government. they do not say that anymore, because they recognize that among the overwhelming majority of the american population, we are actually satisfied with our government and like our constitution. we cannot see a need for global government. they have changed the formulation and it is now global governance. the world federalist society no longer exists. it is now called citizens for global solutions or some innocuous phrase like that. the fundamental thrust remains. america's attachment to its constitution is seen as an anachronism and that the progress we want to make is toward institutions of global governance. the europeans once again are leading the way.
they think that their problems over the last century were caused by the pillar of the nation's state -- that failure of the nation's state. their answer to the problems as they perceive them is to diminish national sovereignty, to pull their sovereignty through the european union and thereby eliminate other sources of conflict. they think they are having a great success in europe. there are serious political figures in europe who say that the disease -- the peak of communism and collapse of the soviet union -- defeat of communism and the collapse of the soviet union was in part because of the european union. they actually believe that. it seems to have lost the united
states and nato in the shuffle. they're not cognizant that even today, their ability to integrate politically and economically and have a very low defense expenditures that they do is because of the raiing united states still holds around the pre-world. i do not want to give the impression that they are selfish. -- still hold around the free world. they are determined to spread it to the rest of us. the work through the united nations and other international organizations to help, -- to help accomplish that. they have decided -- at least at the elite level -- they have decided that the loss of national sovereignty is a plus. they argue to us that the divisions of our national
sovereignty would be positive for us as well. sovereignty is a term with a lot of definitions. for many people it is kind of abstract and hard to get worked up about it. it has been hard for many in europe to get worked up about it. americans view sovereignty in a very different way. we see sovereignty not as an abstract concept, but as the essence of self-government. in the united states, we are the sovereign. the people are the sovereign. that is the whole point of the constitution structure that we is the -- that we established. when somebody says, the solution of global problems requires that you share sovereignty or give up a little sovereignty, that is like saying, you have too much control over your government and
you need to give little bit of it away to somebody else. i do not think we have nearly enough control over our government. [applause] and the notion that we will give up some piece of what little we have -- i find that fundamentally bizarre. that is what the argument is. really, the idea in that sense is that the united states is much different than any other country in the world. if we give up a little sovereignty to this international organization or the other, we're not really losing all that much. my favoriteat you -- of that view is this. my opponent sees the united states as another well be a nation out there on the roll call of united nations,
somewhere between albania and zimbabwe. dukakis got defeated, and obama got elected. that is the direction he wants to go in and minds at -- mindset on which policy is formulated. he is not politically free to do exactly what he wants. there are any number of cases which we have already seen in the first year where he has declined to articulate that doebele -- that view over the. he must have been joking hard to get some of the words out. -- choking hard to get some of the words out. it is important for us to understand what he actually believes in versus what he says about our national security that he feels constrained to do because of the political realities that he exists in.
these things he does because he has to, not because he wants to. i do not think you need to apply the president when his back is up against the wall and he does or says something that he was he born not doing, but he does only because -- that he was not doing, only because of the political reality he lives in. let's take the fight against terrorism. one of the central arguments that the president makes is that we need to show the rest of the world, both are bettors in europe and those in the islamic world who are tempted to a life of terrorism -- we need to show
that in the united states, we are prepared to appear to the rule of law and that we will be true to that in our policies. the implication being that everybody who came before january 20, 2009, did not believe in the rule of law and was not being true to where our -- to our basic national traditions. this is a very important point to address head-on. the fact is that, agree or disagree with the substance of the blessed ministration policy post 9/11 -- the bush administration policy post 9/11, it was in the rule of law consciousness. the difference is how you approach the overall struggle against terrorism. the obama administration has manifestly returned to the pre- 9/11 law enforcement paradigm.
it sees international terrorism as a problem. the way to deal with them is more fbi agents, more prosecutors, until facilities in thompson, illinois. -- thomson, illinois. the obviously correct paradigm is that we are in the war. saying that you believe in the war paradigm does not mean that you are rejecting the rules law. -- the rule of law. it is a different kind of law and a different approach. we believe, as americans, that our military could -- should adhere to the military code of justice. we have training about how the forces are supposed to be hit. when a black -- violate their doctrine -- when they violate
their doctrine, wheat violate -- we prosecute those people. [applause] this is an extremely important point we should not be defensive of. i do not believe anybody in the bush administration knowingly condone the quarter. -- condoned torture. there were lawyers who undertook a difficult task of trying to define a poorly understood term that told us what the line was and that the tactics approved under the label of the enhanced interrogation were not deemed to be torture. when people say they are against torture i agree. americans are against torture, but they understand they are entitled to do what is
permissible within that boundary to defend themselves. the same thing about wanton and obey -- guantanamo bay. it was not an illegitimate facility. it was very hard to deal with very undesirable people. it was -- ask the obama administration why they have not been able to close it. they are coming to terms with political reality. the whole concept of gitmo was to keep us within a rule of law framework. the arguments being made now about how to treat these terrorists arguments based on the wrong paradigm. it is critical that we have a full-scale national debate about whether you think terrorism is akin to bank
robbery or whether you think it is akin to an attack on our country. i think we would win that debate hands down. i am happy to have it every day of the year. it is critical in the broader struggle internationally, particularly when you consider the threat of weapons of mass destruction. what the bush administration did in overthrowing saddam hussein was to take preemptive, military action against the threat to international peace and security. i could give you the long version of why i think we had international legal authority to do that. i can give you the short version -- we were entitled to defend ourselves. yesterday, a commission appointed by the government of the netherlands issued a 551- page report that said the war against saddam hussein was illegitimate because there was no foundation in international
law. all i can say is, if that is the answer they were asking the wrong question. this is another point i think it is critical and understanding -- in understanding the obama administration. john kerry said they had to pass the global test of legitimacy, meaning approval by the u.n. security council. if that is what we have to go through, we will be incredibly constrained, to say the least. that is the way the obama administration's approach is the issues. we can already see that playing out, not just in terrorism, but in proliferation of weapons of mass destruction. we have seen, ever since the inauguration, the administration jason i ran -- chasing iran and
north korea. he is waving at them and pleading with them. why do you not sit down with me? the only thing surprising to me is that they have not agreed to it. in that field of proliferation, negotiation typically benefits proliferators. it gives them a critical asset to advance their objectives -- time it gives them the opportunity as they have demonstrated over the last eight years, to improve both their nuclear programs and their ballistic missile programs. this is a fundamental lesson about a role of negotiation in international affairs and the role of negotiation in a multilateral system, as the obama administration envisions it. it would like people to believe
that they have replaced a group of unilateral cowboys who did not believe in negotiation, who did not only not want to negotiate with adversaries, but did not want to negotiate with friends. that is factually inaccurate for a lot of reasons, but it also misstates the terms of the debate. the real debate is between those who see negotiation in a nationally -- internationally as a solution to most of the world's problems. that is the view i take. the other side of the debate sees negotiation as a solution to a 100% of the world process problems. that is the course the obama administration is pursuing. that is why countries like iran and north korea do not see an incentive to comply -- to come to the table, even after i hear
of desperate efforts to get and there -- even after one year of desperate efforts to get them there. i think this is an indicator that will have a very widespread implications. the world understands that if the united states cannot roll back the north korean nuclear capability and cannot stop a run from getting nuclear weapons, then nobody can stop preparation -- preparation. our european friends may talk about the importance of the iaea, but nobody is deceit. at the u.s. cannot stop this, nobody can. if north korea keeps its program, other countries in east asia will get a nuclear weapons. if iran gets nuclear weapons, other countries in the region, saudi arabia, egypt, turkey, maybe others will get nuclear- weapons. the risk of proliferation will
continue dramatically. the multilateral system of international order reason -- organization is powerless when faced with the dealing with countries like iran and north korea. >> they know that in the current administration they do not have an equal partner. they have somebody they think they can roll. they are acting on that basis and are going to continue to act on that basis. when you look at these critical areas that we have talked about , the administration is projecting weakness in a very substantial way. it is important that we look at otherñi issues that will develop over the next several years, because of the danger is even broader than in the field of terrorism and proliferation.
at some time this year, probably sooner rather than later, the administration will announce an arms control agreement with russia, the deals of which -- details of which are not public. we will probably agree to a substantial reduction in our delivery systems and our weapons. that is something they have wanted for quite some time. moreover, prime minister putin did this a way -- gave this away, they still want us to limit our defense capabilities. the obama administration is doing a good on its own of limiting our ballistic missile defense capabilities. it should not pass our attention that just a few days ago, china announced a successful test of its ballistic missile defense program. i know that arms control discussions caused people's eyes
to glaze over -- causeñi peopl's eyesñrñi toñrñi glazeñi over. my editors threw out a lot about arms control. when it comes to crippxe9ìlk@&c+ ñiprotectant -- crippling the projection of american power, the reduction of our nuclear capabilities and delivery systems puts us in a decidedly disadvantageous position. it will be seen as a signal of weakness, not just by the rogue states, but i russia, china, and others. we will have an epic battle over arms control, and not just in the bilateral context with russia, but over the efforts to put us into a web of multilateral arms control treaties that would prevent us
developing new sources of fissile material, not new jersey -- not engaging in legitimate defense activities in outer space and a whole series of other stuff. our colleagues in the senate are well aware of this. those in the constitution wrote a 2/3 requirement in for the ratification of treaties. make no mistake, this will be a huge source of controversy. even though the announcement of some of these agreements, whether or not they are ratified, will be seen as real evidence for u.s. weakness. the president and a substantial majority of both houses of congress and make unilateral reductions in the u.s. military capabilities without any need for a treaty. the administration has told us that climate change is a
national security threat. [laughter] let's deal with it an. even though copenhagen turned into a debacle, that issue is not going away. the issue of climate change is something that more the proponents of global governance have seized upon as the most likely avenue to advance their broader agenda. the level of rhetoric about climate change has gotten to the point where, if you disagree with the conclusions of those who recommended the measures being considered at copenhagen, you are read out of civilization. they see the level of fear and western countries in particular as a vehicle to advance the
global governance agenda. i do not consider myself able to discuss the science of global warming or the extent to which it has -- the extent to which it is caused by human activity. whatever the tax on global warming -- the facts on global warming and the human factor, that does not dictate the outcome in terms of policy. it will be extremely important, as congress looks at cap and trade and a possible climate change treaty, to reject the kind of international regulatory attack mechanisms the administration and european friends have been talking about. the administration sees climate change as sole important that it has announced -- as so important that it has announced that
satellite is normally used for security and intelligence will be used to help monitor global warming. we're advised this will not hamper our intelligence gathering activities. why not? in all my years in government, i never knew that our satellite capabilities ever had any spare time. you are always competing for priorities. when you see this shift of capabilities to ward climate change monitoring -- toward climate change monitoring, you can see how important this is to our administration. it ties in with the threats to american sovereignty and the question of global governance. these things make up a mindset the administration has. they have not all been manifest
to the extent they would like, because they are not making the progress they hoped to make on changing the health care system. there is no doubt in my mind that they will turn to these things at their earliest opportunity. we either deal with these issues on a broad philosophical level as well as on the level of specific issues, or we will find ourselves continually at a disadvantage. i think it is very important to address the larger issues, because fundamentally, the american people share our view to a very considerable extent, that we actually liked our independence, our constitution, self-government in the united states. these alternatives so beloved of our friends in the obama administration are decidedly not the way the country wants to go.
thank you very much. [applause] thank you. i think we have time for a few questions before the next panel. people should come up to the microphone or just speak loudly and i will try to repeat your question. >> where does israel fit into what you are describing? will they have to fight a run by itself? will it be able to fight -- will it have to fight iran by itself? will it be able to fight the obama administration? >> after seven years of attempts to and negotiate with iran, it
is clear they are not going to be talked out of all weapons capability. it has had one consequence. they are now seven years closer to a deliverable nuclear weapon. the time for diplomacy has long since bailed -- failed. there is no chance of economic stations diverting them from its now 20-year long effort to get nuclear weapons. our metric should not be can sanctions caused them some economic pain. for the sake of argument, come up with new sanctions that could do that. is there any conceivable set of sanctions adopted by any conceivable set of nations that wilson -- that will dissuade them? the answer is no. the most likely outcome is that they get nuclear-weapons. once that happens you will have
further proliferation in the region and be in a situation in a few years or half a dozen countries in the middle east have nuclear weapons. if you did not like the bipolar standoff of the cold war, imagine a three dimensional test -- chess of a multi-nuclear standoff in the middle east. the only remaining possibility of preventing them from getting nuclear weapons is to preempt -- is the printed use of force. it goes without saying that the obama administration is not going to do that. that means is real -- israel. the issue of the use of force for self-defense, before an actual act of aggression occurs --it is important -- it is important.
faced with that kind of threat, it is important to justify eliminating it. it is a justifiable use of force. i do not know what the obama administration's reaction would be to an israeli use of force. it is a major complicating factor in their decision. i want to emphasize that the choice is not between the world as it is today, compared to the world after the israeli strike -- that is not a choice. the choice is the world after an israeli strike, compared to a world where iran has nuclear- weapons. that is why difficult, -- as risky and unattractive at the use of force is, it is a decision israel will have to make in the very near future. [applause]
>> could you say a few words about the possibility of the iranian opposition overcoming the current regime? what might they do with nuclear weapons? what can we do to reach out to the opposition regime? will they be tarred by the brush of being pro american? >> the regime in tehran is extremely unpopular -- in iran is extremely unpopular. there is enormous dissatisfaction with the state of the economy. the young people there, who amount to 2/3 of the population under 30, they know they could have a different life. they are educated and sophisticated. there is enormous ethnic dissatisfaction. only 50% of the population is person. these factors do not necessarily overlap. --only 50 % of the population is
a person -- only 50% of the population is persian. the united states had done very little to assist the opposition. if we had done more, the spontaneous outpouring that we saw after the fraudulent june 12 presidential election might have been a moment of opportunity to throw over the regime. but we had not prepared the groundwork for it. there was nothing we could do in that aftermath. in fact, the situation was worse -- is worse today than it was five years ago. overall, power has flowed away from the ayatollahs award revolutionary guard and the people with the guns. it is a very unequal contest. that said, i would support the opposition.
you are right to say we have to be careful in how we do it so that we did not taint those who we are trying to help. you cannot turn regime-changed on and off like a light switch. -- regime-change on and off like a light switch. the race is not on stopping them from getting nuclear weapons, because i feared that there is at least the possibility that, if they get nuclear-weapons, and is then overflown, even of representative government might decide to keep nuclear weapons. i hope not. i hope the fall of the south african example. -- i hope they follow the south african example. you do not have anything to worry about from a nuclear iran -- i do not think that is a
convincing argument. the critical importance of stopping iran from the nuclear- weapons argues in favor of taking the necessary steps, even if that put popular opinion back toward supporting the regime. i do not relish the process. the overwhelming objective has to be to keep them from getting nuclear-weapons in the first place. >> you recently wrote about intelligence. we talked a little bit about military roles in afghanistan. the cia and has been very active in fighting al qaeda in afghanistan and have lost several lives including the recent bombing. danny discuss the -- can you discuss the iraqitization?
>> i think we have the most sophisticated technical means of gathering intelligence of any country in the world are none -- bar none. where we lack in intelligence is in human intelligence. i would take a very substantial chunk of the budgetary authority that is now spent on analysis in the intelligence community and move it into operations. we need to get facts to decision makers, not essays on the state of the world in 50 years. the bureaucratization of intelligence has been accompanied by -- politicization.
pop it were -- i did not see that at all. i have never seen an intelligence analyst who is not prepared to defend his or her work. i would have more competition within the intelligence community. i would let policymakers make a judgment on the basis of the evidence that stands up to scrutiny. in addition to having a greater human intelligence capability, we need greater clandestine operation appeared ability. one reason the military has taken on the role it has is because the cia had lost that ability. we had spent close to four decades since the commission's eviscerated our intelligence capabilities. it is time for change.
we rely far more now on what we euphemistically call liaison services. it is not safe for the country, get our national security adviser has said we're going to have even greater reliance on the liaison services. that is the wrong way to go. we're spending $800 billion on a stimulus package. i would have spent more on recruiting at the cia and less onerous shovel-ready projects -- on shovel-ready projects. >> i would love your take as a lawyer about exposing be as long as agenda -- the islamist agenda. i would love your take on this -- the problems of incitement nurses and free speech --
insight into -- incitement versus free speech. >> the ideas of hate crimes have a historical context that we not have in this country. i believe in the free marketplace of ideas. [applause] i understand why the europeans have those kinds of -- because of the history. i think it is wrong for them and wrong for us. the argument that is now being advocated, that we need to be sensitive to religion in protections for people -- and need protections for people -- there used to be lost all blasphemy laws in europe -- to be blasphemy laws in europe.
it should be rejected. i hope we do not see that kind of political correctness spreading into our legal system because it is poisonous. [applause] >> thank you. >> in order to keep on schedule, that will be the last question. thank you for coming today. good luck to you. thank you. [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010] >> we're going to take a five minute break before the next panel. that was terrific. >> john murtha of pennsylvania died today at the age of 77 after complications from gallbladder surgery. president obama released a statement that said, "john
murtha's passion for service was born during his decorated career in the united states bring corporate he went on to have the distinction of being the first vietnam combat veteran elected to congress. his reputation carried over to congress when he became a respected voice on issues of national security." he was elected to congress in 1974 and spent nearly two decades as the ranking democrat on the house subcommittee that oversees defense spending. >> in a few moments, health and human services secretary kathleen sebelius will discuss the president's health care plan. >> in 40 minutes, margaret hamburg. a discussion of climate change from the world economic forum. later, a look at the
congressional agenda leading to this year's elections. prime minister's questions or parliament in london is live on wednesday morning at 7:00 a.m. eastern on c-span 2. gordon brown takes questions or half an hour. also wednesday, coverage on the hearing of toyota vehicle recalls. ray lahood will testify. that is on c-span 3 at 2:00 p.m. eastern. >> c-span offers a new cs and classroom, redesigned to make it more useful for teachers. it has the most current and timely seas and videos for use in your classroom. find video clips organized by subject and topics. you have the chance to connect with other teachers.
it is all free. sign up online. >> health and human secretary service -- health and human services secretary kathleen sebelius. it is part of a conference or health policy analysts and researchers. the comments to the group are 40 minutes. >> this conference has been organized for the 10th year. i did not think there was a lot in common between working and planning for months and having a clear agenda and knowing exactly what you're going to do and having 30 inches of as now -- of snow interrupt the brilliant planning. it feels like the day after the massachusetts election. a little regrouping. i am delighted to have a chance to visit with all of you.
i was struck when looking at the agenda about how much there is in common with the the kind of topics you will talk about in the next couple of days and what we really deal with in the office each and every day. first of all, you have a terrific lineup of speakers and panelists. i am really pleased you will hear from dr. hamburg right after me. she is one our great new leaders. i get to hang out with some of the most brilliant scientists in health policy. you have assembled many of them here today. issues like how to use the new technology to empower consumers. how to create incentives for providers to deliver better care. how to invest effectively in prevention. those are some of the challenges that we are dealing with within
the department each and every day. the same questions we are asking. i am sorry we -- i cannot join you for the full presentation, but anxious for you to share read me the good strategies and ideas that you come up with . i want to start by giving you the administration's view on health reform and where it stands now and where we see things going. let me tell you that the president and administration are as committed to delivering on a conference of health reform now as ever. the president is very determined that, not only does this need to happen for the citizens of this country, but it is six essential
for the economy of this country. every day that goes by an ever report that comes out reinforces his notion of how this is tied to our economic survival and our economic progress. this is really not about a legislative victory or proving a point, as he said in the state of the union address. it is not about his political standing, or he would have chosen some bindles to start with. -- chosen something else to start with. he feels strongly that this is one of the determineing issues about the future of our country and how prosperous we will be in a global marketplace and how healthy are citizens will be in this competitive world in which we live. we know about the human stories -- the mothers who are paying for hospital bills because
there is a pre-existing condition and it cannot get the insurance they need, or a steel worker who sees his will pay go down because of more salary of diverting to trying to pay for health care plans, or seniors to go to the hospital to get treatment for urinary tract infections, only to end up dying from us staff infection -- a staph infection that they get in the hospital. or there are younger people who continue to worry about whether or not the promise of medicare may now -- will ever be there for their future. there are lots of individuals around this country who are worried about the system. they do not know what the
answers or solutions are. we had our own kind of interesting moment -- a little glitch in the health care market. i am the mother of two 20- something sons. when they graduated from college, neither was in a job which provided health care. we were lucky. they are healthy. they had not a lot of trouble finding pretty affordable assurance -- insurance and we had resources to help them. i watched a number of kids who -- one had a previous football injury, another had some treatment early on in high school for a series of challenges he was phasing with drugs and alcohol -- neither of whom could get insurance in the marketplace. they really had to spend time struggling and trying to figure out what the options were and hoping to not be in a situation
where they ran into an accident or disease that they really could not cope with, knowing that they would face a lifetime of crushing bills. there are people looking through the lens of the uninsured or underinsured or those who have insurance, understanding that that is a very tenuous situation they are in. we know that the process over the last year has been confusing to people. when you talk to people -- when i have that chance to travel around the country and visit with people to visit and ask what the elements are in the house and senate bills, there is overwhelming support for the measures to be enacted. when people watch up close and personal, the activity of congress -- they tend to be very, not only confused, but
sometimes disgusted with the process and do not want anything to do with it. they're too afraid that whatever is going on cannot possibly be good for them or their families. we know from beyond a personal story about what this is doing to our economy. i deal with people in the small- business market. one of my friends, the new small business administrator tells me this conversation happens all over the country. small-business owners who are often in the real crunch of the marketplace -- they say one of two things. they may have dropped coverage altogether because they cannot afford the dramatic increases they are seeing, or they lose employees to people who can afford much better coverage. they cannot stay competitive in this marketplace. their choice is often between keeping employees and keeping
health coverage. the cannot do both. we know that our entitlement programs of medicaid and medicare are on track to be broken. . of money in the next seven years. we're at a point in this country where we spend almost double what any nation on earth spins on health care. we are according to the report last week spending 17% of our gdp on health care. gdp on health care. the largest one-year increase in e last 40 years is the jump in health-care costs. compared to what is going on with the rest of the economy. we live sicker and i agree that many countries on earth.
danish ministers were coming to the u.s. to talk about the work we're starting on prevention. i was struck by the fact that in denmark, the their per capita health care costs are $3,300 a year and we're up over $7,200 a year. their health measures in virtually any area you can choose our better than ours. some of that can be explained with the relatively homogeneous cultures and issues we may not have with diversity of health experiences. there is too large a gap and we are spending too much money and
getting worse results. both congress, both houses of congress have worked on this for years. there are numerous good ideas and they have much in common. when the push for reform started, a lot of people said we cannot do it now. we cannot take this much time. i think once again that it is so intimately tied to our opportunity for economic recovery that we have to do it and we have to do it in a way that not only are the bills paid for, and did not add to the deficit, which is different than most recent health reform that was passed by the previous administration the plan b drug benefit that was not paid for in
part of our growing deficit. the president is committed to having this paid for but also, looking at ways that the system is transformed into a much more cost-effective, higher quality system in the long run. if we pay for what we're doing and continue to do it into the future and add 45 million to the existing system, we have not made any progress. we have not change the trajectory which is now indicating that we will not be able to afford this system into the future. we have to have as part of the system of way of delivering medical care and change and not only payment practices but delivery systems and a way to tackle some of the underlying causes of our extraordinary costs. those are key elements in the reformed system the president
has invited key members of congress to join him on the 25th of february. he is hopeful this is not one more conversation about various components of a plan but hopes the republicans are willing to come forth with their own plan. not just criticisms, but a plan. had you planned to address -- how do you plan to address reduced costs in the system. and taking $1 trillion of the deficit as a significant step forward from where we are now. covering all americans, having a delivery system that begins to focus on wellness and prevention and not just wait until we deal
with acute-care. come together and move forward. a lot of people have said is the starting over and the answer is absolutely not. there are comprehensive proposals on the table. he is ready and able to add to or at various elements that may be missing. we have to -- the republican members have to greengage. i think it is not acceptable that half of the legislative body is pushed away from the table when the conversation began and say we do not want to participate in this process. discussion was we do not want to participate in anything that has a public option. we cannot talk about any kind of insurance strategy.
as far as i can determine, the public option is no longer part of the plan. no one has come back to the table and said we will talk about how to move forward with the private market strategy. we're hoping that will happen in february. we will continue to work the house and senate leadership -- the house and senate leadership are willing to discuss with each other what is the best pathway for. the president remains committed to the notion that we have to have a comprehensive approach. the pieces of the puzzle are too closely tied to one another. it is disingenuous to say we're for the insurance reform and yet do not support the notion that everyone would have to come into the marketplace. if you have a private market system without rules that allow them to cherry pick the system, and do not require those who are well to buy insurance, you
have effectively destroyed the insurance market. he will have an adverse selected pool and you will only have six people in its and the costs will skyrocket. i do not think it is a genuine step forward to set want to provide coverage for all americans and yet, not recognize that there are lots of working americans who cannot bear the four -- cannot bear the costs of providing coverage and they are not in a job situation where there is an employer contribution. without some subsidized assistance will have an offering of coverage which we do now but not the affordability of coverage. pieces of the puzzle are necessarily tied together if you have a comprehensive approach and cost containment has to be part of that comprehensive approach. i think both house and senate have made sure there are ideas
on the table which we feel will not jeopardize benefits. but actually move us in a direction where [unintelligible] for not following appropriate protocol. cause for reform in -- and the case for reform is still fundamentally before us. it is a conversation we have had in this country for 70 years. i also was not part of those original conversations although some days i feel like i was part of those original conversations. the message is pretty straightforward. we need to finish this job. we need to step up and finally
deal with a comprehensive health reform in america because our economy cannot afford us to do anything less. our health system is fundamentally broken and needs transformative infusion of assistance and i think there's no question that millions of americans are desperate for some sort of health security that they do not have now. reform itself, the comprehensive look at the health insurance system and changes in delivering prevention systems does not magically transform all the issues facing us in our health system. it would be a huge step forward and be the biggest step we have made in 40 years. our health system did not begin and end with health reform and
was never going to stop when the bill passed. which is why for the last year, we have been working on some underlying features of the system and will continue to work in all kinds of strategies with proposals that are contained in the 2011 budget which fit as companion pieces to comprehensive health reform bill moving forward. one of the first bills that the president signed into law last year was the expansion of the children's health insurance program which has been enormously popular and enormously successful. in insuring children across america. we put out a report last week which looks at the baseline numbers and in spite of this economic downturn which has been experienced by every state in the country, to a half million more children have insurance and a year ago. either enrolled in medicaid or
in schip programs. states have work to expand their coverage options for kids. in spite of tough budget times and choices, they understand that that is a fundamental step forward if you want to have a prosperous state, if you want our kids to do well in school, they need to be healthy at the outset. children's health insurance continues to be expanded. we have a challenge. we think there are approximately 5 million american children who car -- currently qualify who are not yet enrolled. for the first time with the passage of the legislation last year, congress appropriated some average money and we're working diligently with partners, not only across my cabinet colleagues and government looking at the various programs that people enroll in that we might make it more an auto
enrollment in children's health insurance, we would alert parents at a minimum but conceivably and roll folks, but working with states, our faith- based partnerships, with average organizations, and i am asking all of you when you return to your home areas, if there are ideas or strategies that you have about enrollment opportunities. what we know is that some parents still have no idea that they may be eligible. others have listened to the discussion, we have heard this a number of times about health reform. they have to wait until health reform is passed, they think, in order for their children to qualify. they do not understand that bill was passed and written into law. some have been enrolled and because they move door because they did not fill out the proper forms are not enrolled and we need to reach out to them. we are looking for great
partnerships to make sure that at this tenuous time, when families need it more than ever, that we actually have an aggressive and non-traditional outreach effort to try and get the word out to folks that they are indeed available for coverage. another huge investment in the public health infrastructure which i think is essential moving forward and continues to play a major role is the continued expansion and investment in community health centers. during the recovery act, there was a major new investments, not only updated centers that are currently in place, but a major new footprint in areas underserved by health centers. what we know after a member of years is that -- a number of years is that high quality low-
hells becomes a component of what is available and offered -- health becomes a component of what is available and offered. mental health services become a component, so in the president's budget for 2010 and again the proposal for 2011, that will continue to expand and be strengthening our primary care delivery, and what i have seen in the creative strategies going around the country is community health centers working in close partnership with community hospitals to develop some release strategic health plans were the patients are essentially -- even if they come through an emergency room of the hospital, are quickly
referred to a health center for fred -- for primary care. it reduces the strain off and on hospital settings and gauges a family with all home care provider and primary care provider and delivers care that is cost-effective and often culturally sensitive. sensitive. we have a major investment that started in the recovery act and has continued in the budget. we need more health care providers. we need more doctors and more nurses, mourners practitioners, more mental health professionals -- more nurse practitioners, more mental health professionals. we need an increased emphasis on non. -- non-traditional providers.
men and women who will serve in underserved areas and providing a reach for spanish-speaking providers and multiple language providers. often the health barrier deals with cultural continents' and unless we make an enhanced effort to have a diverse health work force, we will still have lots of barriers to health care delivery. the president has made it abundantly clear to members of his cabinet that he takes very seriously the stewardship of taxpayer dollars. one of the areas that we know has a great potential for recovering tax dollars is in the area of fraud and abuse. there are all sorts of estimates about what kinds of fraud made take place in the medicare --
may take place in the medicare system. i do not know who has accurate numbers. there are national groups to say that you can estimate that in any enterprise, 3% of business is likely to be fraudulent. that is a huge number for a system like medicare. it could be as much as $60 billion if that were accurate. what we know is that there are billions of dollars. medicare is a system which pays over $1 billion of claims each and every day. a lot of money moves in and out and that makes it a huge target for fraudulent activities. what we have seen over the years is the activity used to be pretty unsophisticated. mom-and-pop operations. it now is a target for a much more serious, organized criminal
activity. we need to actually really stepped up -- step oup our activities to prosecute and prevent fraud. thiwe have been asked to convena multi agency operation, the task force we put together and part of the goal was to use data to analyze ever and billing practices. some of you have probably had situations where you will get a call from visa or american express saying did you make a charge i am but a cerus -- buenos aires? were you in boca raton in this
date? they have analyzed what are the billing practices and want to get ahead of what may be fraudulent activity. we're doing a similar operation where we now have an opportunity to share real time data with those at the justice department. we have analysts who are looking at various patterns to try and have boots on the ground to go and quickly check out what in the world is happening. the strategies are paying off. later today, you have a panel dealing with geographic variation in health care. let me give you an example of how we are using our current tools. miami-dade county is home to 2%
of the medicare beneficiaries who are receiving home health benefits. in recent months, they have 90% of the home health patients receiving more than $100,000 of care every year. you do not need a ph.d. in statistics to see that something is going on. in fact, we moved one of the strike forces into the miami area, one of the first places that we targeted within a short time, literally billions of dollars in home health billings dropped, just having the presence of people on the ground verifying. they have moved someplace else, unfortunately. this has to be, we now have seven strike forces throughout the country. we have asked in the new budget to have resources for up to 17 cities.
more than that, i think the data sharing, the verification we started doing new pre-screening spoor providers coming in. we need to -- make sure that people are not just hanging out a shingle and making themselves out to be a medicare provider. there is tha service being provided. making sure these activities are legitimate but it is something we're taking very seriously. no question in this country that we are behind a lot of the rest of the world in our use of technology in the health system. it is still fairly stunning to me that in the vast majority of hospital systems and doctors' offices, we are using paper records. i cannot imagine any small
operation in the manufacturing sector that would be using a written list and hand mailing it to someone in hopes the delivery would take place. that is the kind of technology that is in most providers' offices today. congress and the president made a significant investment in developing a national electronic health records platform in the recovery act. what we're hoping is that we can provide enough incentives to have the tipping point that the market will took over. this is not that the government will provide the technology, but what we know is that without a platform, without some assurance that these systems will be interoperable, without some
incentives and assistance, particularly for smaller providers or community hospitals, we will stay in our papered world. the technology move is under way. we have already seen systems in place in pockets of the country where very positive patient outcomes are achieved because of the use of technology and health systems. one health system was using electronic health records to identify older women not receiving osteoporosis screenings on a regular basis. the screenings went out and identified some folks with real problems. one-third of diabetes patients
in another system were receiving regular eye and foot exams as is necessary in a diabetic. the tracking of patients, monitoring with electronic records and following up carefully in terms of who got exams doubled the amount so that two out of three of the patients is now receiving the appropriate follow-up care. the recovery act investments, the ability to put extension systems on the ground to do outrage to particularly small providers in underserved areas, to be the kind of tech centered helper's led by dr. david blumenthal, who is not only a great leader in this area but comes to this perspective by a
practicing physician who uses electronic records. when he deals with providers, he describes himself, i am not the technology gate. we have those folks in the system. i can tell you how as a doctor this informs my practice and made me a better health-care provider to the point that i would never go back to practicing any other way. it is a way to virtually integrate a lot of health care practices. doctors and hospitals do not necessarily need to be in the same system. not even in the same city but the kind of opportunity for coordinated care and bundled care and follow-up and monitoring. we know it can have enormous successes and when used appropriately, the opportunity to lower medical costs and increase the high quality care delivery is extraordinary.
that also is under way. we continue to understand looking at the data then again, we have a huge problem in this country with chronic disease and chronic disease driven by some very clearly identifiable underlying causes. smoking, obesity are two where there is a huge opportunity to change your health care cost estimates into the future if we can deal with some of those underlying causes. i am pleased to be joining the first lady tomorrow in her kick off of her childhood obesity initiative which she sees as a multi-year effort to tackle what is the true health crisis in this country, where we now have one out of three american children are overweight or
obese. that is double the number 40 years ago. it is getting no better. there is enough childhood type 2 diabetes that is no longer called adult onset diabetes, we just collotype to because -- call it type 2 because more children are presenting with diabetes. we have the first generation of american children who will have shorter life spans than their parents. alive right now. it is a serious issue. we know that smoking dropped dramatically in the u.s. over the years but has unfortunately level off at 20% and it has not dropped in a number of years. not only is there a new era -- new aggressive effort at the fda which i am sure dr. hamburg will
talk about. there is a host of strategies to see what it is that can influence people, smokers to stop and hopefully influence our younger americans never to start in the first place. congress made a major investment in prevention and wellness as part of the recovery. -- recovery act. programs will be in place around the country, mainly aimed at tobacco cessation and be city and community grants will be announced later this month. we will have 37 communities, urban and rural, some tribal urban and rural, some tribal communities that will
we will really be able to figure out what will work and be able to drive it to scale. when 75 cents out of every health dollar is spent on chronic diseases, the more we can have early intervention, the more we can change that pattern, the more we can make sure 50- year-old still not end up with diabetes but dealing with -- deal with it when they are 12 or 13. the lower the cost for the nation will be. these are important steps to make it a more prosperous country, and we're going to keep working on this and a host of other strategies, dealing with health disparities, continuing to look at innovative countermeasures, trying to make sure we are on the forefront of
the number of initiatives, not only in the country but around the world. there is no question comprehensive health reform is an important and integral part of strategies moving forward. if we did all those other initiatives and did them well, we still would have a huge gap in our health-care system, and we would frankly be in many cases moving money around the system. those with insurance are paying an extra cost for those who do not have coverage. we have millions of americans who can access high-quality preventative care on a regular basis and do not seek care until they are often too ill to be treated appropriately or dealt with very adequately. adequately. we will still sees to be competitive in the global marketplace where virtually none of our comparecompetitors are
dealing with the kind of major health gaps that we have here in the u.s. these pieces of the puzzle are tied together and we at dhs -- hhs take them seriously. i am confident we will have a comprehensive health reform measure passed and signed into law this year and i am also confident that we have an opportunity with that piece as well as these initiatives in technology and prevention and wellness, a new way to look at health in america to make some really transformative changes that will yield a more prosperous, healthier nation over the next decade. now, another new course we have in the department is our effort to build a 21st century food and
drug safety system. it is a charge that the president has given to us and we take very seriously, given the fact that our marketplace looks different than it did 25 years ago. we need a regulatory structure that looks different than it did 25 years ago and i am delighted that you are going to hear from another of our great new leaders at hhs, dr. peggy hamburg, who were wer were able to convince o be with us. thank you for braving the weather conditions. i understand we have another six to ten inches. we love having you here. we can use your expertise on a regular basis. we have lots of challenges to deal with. deal with. into the spring and summer.
leadership and support. she has made a record in terms of how quickly she came on the job and had to face major challenges, first with the global pandemic of age one in one and as our country has had to deal with health-care reform -- pandemic of h1n1 and as our country has to deal with health care reform. i deeply appreciate the work all of you are doing to sort out difficult and complex problems with our health care system and with the help of our nation and to help us be able to provide higher quality care to patients and to be able to improve the overall health and well-being of
our nation. i was not at all sure this meeting would go forward. i admire the determination of the leadership. i sought snow would probably do a sin, and -- i thought snow would probably do us in, and at minimum i thought i would be addressing a relatively empty room, so when i look at all of you, i am really impressed by your dedication, and i must say, i am happy to get a warm welcome. when i took this job last spring, i was a little worried about the kind of response, whether or not i would received when i was introduced as commissioner. too many people offered me condolences along with congratulations when i was first appointed.
many wondered why won't want to take on the position, but i have been surprised -- wondered why i would want to take on the position, but i have been surprised by the support i received. almost everybody i had met with shows real commitment and interest in the success of the fda, a real desire to help support me in this task, and it is clear why. all of us eat. all of us need medicine from time to time. we all have families we want to keep safe. each and everyone of us needs an fda that can do its job and do it well. the challenges are daunting. consider that the fda regulates 20% of every dollar of consumer spending in this country. drugs, medical devices,
vaccines, cosmetics, tobacco products, animal drugs, and even certain products that emit radiation. to add to the challenge, an increasing percentage come from overseas, creating new challenges and insuring the safety and quality of our food, drugs, and medical devices. what i would like to do today is describes some of the priorities and perspective i bring to this job and how they are being addressed. the late senator kennedy, one of our nation's great champions of health care, once said the fda is the most important health agency in the united states. this is a surprising statement to some, but the more deeply i am involved, i learn every day about the important work of the
fda, and the more emphatically i understand and share his view. congress has given fda strong regulatory power. the public expects us to take action to make sure the products we regulate are safe and high- quality, but we are also the gatekeepers, with a major role in getting new products into stores, pharmacies, and hospitals. in those areas, preventing and countering threats to health and furthering innovative products, we have a unique role and responsibility. if we cannot do our job and do it well, there is no one else -- know when in government, the private-sector, the not -- no one in government, the private sector, academia, who can step in behind us. ironically, when we succeed, we are often invisible. the outbreak that did not occur,
the dangerous drugs that never made it to market, but when we struggle, our mistakes are usually glaringly visible. moreover, if we miss the signal that indicates problems with drug safety or if we miss a date for an important new drug, patients can suffer. throughout our history, the fda has been the target of claims that we are too slow to improve products, too quick to jump at the side -- sign of the safety problem. other critics say we are to industry friendly and allow to many dangerous products on the market. this is a hard job. the challenge is how to steer the ship in often choppy waters. my approach has been to use what is in fact fda's historic
mission -- the promotion and protection of the health. this public health perspective -- not surprising, as i have worked in public health most of my career, the loyd train recently to be an academic researcher, but what does a public health perspective really mean? the institution of medicine has defined public health as the interest in ensuring conditions in which people can be healthy. be healthy? sure, people need access to a safe food supply and to the safest food possible. the fda's role is to support this access and to promote health, prevent illness, and prolong life. as i said, most of my career has been in public health. it began nearly two decades ago when i stepped into the position of newark's city health
commissioner, -- new york city's health commissioner, and at the time, my great aunt was actually very upset by my decision. she complained to my father she could not understand why i did not want to be a real doctor. why was i taking on this strange government role? my father tried to offer some consolation by saying i did want to be a real doctor, but net now i would have -- but that now i would have a million patients, and now i have 300 million. what are the key challenges? in my view, the fda must work to prevent problems, to balance benefits, and to monitor out comes. my goals are to modernize fda's work in all these areas and to strengthen credibility in doing so. these goals are intimately linked.
it is linked not just to strengthening the fda and the important work we do, but also to the role in the health-care system and in a globalized economy, so i want to discuss each of these key areas. first, the fda must try to prevent problems before they occur. one good example comes from how we address food safety. in late 2008, there was an outbreak of salmonella related to apeanuts. most of you probably recall this. i know it had a powerful effect on the president. he just came to office as this outbreak was hitting its high point. the agency did not take aggressive enforcement action
until after there were confirmed cases of illness. in the end, a people lost their lives, and thousands were made sick. by contrast, last april, a number of months after this peaked as a problem, we learned a california company was contaminated with salmonella. this year, the fda warned consumers not to eat pistachios while they investigated the extent of the problem. we soon found the source of contamination, identified the problems involved. the company issued recalls. from that beginning of the investigation we worked closely to identify products -- first the products at risk and the products that were saved. within a short time, people could start eating pistachios
again. the situation was admittedly different, but between peanuts and pistachios, fda had begun more prevention. we now also have a food registry which requires companies to let us know of any safety problems with their ingredients before anyone becomes ill, and we're waiting for the senate to pass a major food safety bill. the bill has already passed the senate committee. this bill is really important, because it will provide important new resources to the fda. it will give us the ability to do mandatory recalls, give us routine access to safety records for factories and farms and to make sure the facilities develop and heavier -- and adhere to
save processing. these are important to us if we want to regulate rather than just to react. most businesses agree as well. they understand when an outbreak of food borne illness occurs, it is deeply damaging to the food company responsible and can hurt the entire industry. the salmonella outbreak not only killed and sickened people, but it shut down plants, through workers out of their jobs, and led to recalls that cost the food industry about a billion dollars. preventing problems also applies to medical product regulation. that is reason for the quality by the same rigid quality by design program and other measures to address safety across the lifestyle of
products. across all of our regulated areas, we're asking not just to have to fix -- just how to fix the problem, but how to prevent it. when we see problems, we cannot be afraid to take actions necessary to stop them in their tracks. too often, the agencies have found themselves going back and forth with serious problems remaining in limbo. my view is when the health of the public is jeopardous, we have a duty to warn and to act. shortly after i took office, i learned about a growing body of evidence that a certain product was damaging the smells of consumers. there were world -- well over
100 people who seem to have permanently lost their sense of smell. we warned consumers not to use these products, and manufacturers remove them a week later. this is a good outcome, and we will always act when public health is at risk, but enforcement is only one of the tools. the second critical test i want to mention is a fairly balanced benefits and risks. where there is much risk and little benefit, fda should pull products from shelves. where there is much benefit and little risk, we should step up the efficiency of the process or actively urge people to receive the benefits, as they are currently doing with vaccinations against the h1n1 flu. there is that gray area between
where products have a serious risk and important benefits. in this case, the fda must use all its tools to maximize the benefits and minimize the risk. to maximize benefits, we can help director product to those who can use it both. to minimize risk, we can investigate problems, including such things as genetic markers, and educate care givers and patients about who should or who should not use a product. all the while, we should be monitoring the impact of our actions and using this information to decide how much more or less we should do to help the public. the third key area to focus on would be an assessment of outcome. we cannot measure success only by the number of facilities we inspect or drugs we improve or whether we are following the regulatory guidelines. the true measure of our
successes the health of the american people. we must keep a close eye on rates of food borne illness. for medical processes, we should keep an eye on the needs of the population and whether we have regulatory pathways to meet them. we have shown in the past year, the fda can clear red tape to get products to consumers in emergency situations. for example, as a result of pandemic preparedness taken place over many years now, fda was ready when the flu pandemic began to take extraordinary steps to protect human lives. we immediately authorize the emergency use of newly developed diagnostics so that people could be tested for the disease as a guide for treatment and for tracking the epidemic. in addition, we made anti-viral
drugs available and circumstances where they may not have been licensed but were they save lives. we base our decisions on careful views and risk benefit analyses developed by these products. we must also be aware of where patients could be suffering adverse consequences. last fall, the fda launched an initiative, encouraging medications to be used safely, meaning in part, not accidentally ingested or overdose, not given to patients who will not tolerate it, not prescribed in inappropriate ways, and not used inappropriately by patients at home. some thought this was going a bit beyond the role, but we thought it was a vital part of our role, and through this
effort, we are partnering with a wide range of allies and will monitor our part s -- our progress closely to make sure we are on the right track. we have a lot of important task before us. unfortunately, over many years, the fda has not gotten support necessary to fulfil our important mission, but i do hope and believe we are turning a corner, that growing appreciation -- with growing appreciation, it is in everyone's interest to have a strong, fully functional fda. we are embarking on a new era of prevention with support of the white house and congress. last week, president obama released his 2011 proposed budget, which contains significant enhancements for key areas of the fda. there is a long way to go, but these are exciting times.
recently, we have been entrusted with the unprecedented task of regulating tobacco products, the number one cause of preventable illness. we're safeguarding our food supplies while looking forward to the passage of legislation that will give a significant new authority and some resources to support this area of work. we are implementing new strategies to enhance consumer safety while supporting innovation, and we're working hard to bring the fda into the 21st century with respect to two key areas of activity -- science and globalization. before i close, i want to say a little bit about each of these areas of activity. first, with respect to science, we are moving forward to strengthen and streamline the science of our current regulatory procedure and implement new strategy is to guide our work. as you may know, the number of
advisory boards have warned about the dire state of science funding at the fda and how the scientific and regulatory demands. clearly, this cannot be allowed to continue. in everything we do, a fundamental authority must be strengthening science. in everything we do, the fda must demonstrate it is the science-based, science-driven agency. we must be ensured we always use the best possible science and data to guide our decision making and thinking. we must get in size from the best possible expert and always be prepared -- get advice from the best possible experts and always be prepared to change our mind. it is obvious the agency comes with the responsibility of judging the safety of medical products and monitoring the safety of those products and other products, including foods
and cosmetics. it needs to resist the scientific capability equal to that task, but while that statement may seem logical, the fact is in terms of investing in the kinds of science we need to advance as a nation, fda clearly needs more resources, and the president's budget reflects that, but it is more than that. just as medical science research has evolved, regulatory science, the science and tools we use to assess and evaluate product safety, effectiveness, potency, quality, and performance must also evolves. i also use the metaphor of a rower on the potomac with one powerful muscular arm and one scrawny arm, rowing with all of his or her might. it is inevitable the boat will not go on a straight trajectory forward. so it goes that u.s. biomedical
advances over the next several decades, basic science is pulling hard, but it also takes muscle to create innovative tools, standards, and approaches for the fission assessment -- the efficient assessment. promising therapies may be discarded during the process. an outmoded -- of mountain revue message can delay approval of critical treatment -- outmoded review mess since can delay approval of critical treatments. with better -- outmoded revue methods can delay approval of critical treatment. a robust state of the artt(
regulatory science is essential to fda's work, yet it also represents an important driver of our nation's health, our health care system, and our economy, and it is a goal we must all obey. i feel confident if we do so, we will be able to speed the movement of new discoveries and practical applications, and we have seen examples in the recent past where concerted scientific advancement led to the approval of new drugs in remarkably little time. this has a very personal resonance with me because when i trained in medicine, i watched the emergence of the aids epidemic, and when i was doing my residency in internal medicine in new york city during the mid 1980's, i was taking care of a lot of aids patients. at this time, we had virtually nothing to offer besides
supportive care. there was so little we could do. shortly thereafter, i went to work with the national institutes of allergy and infectious diseases -- first as a special assistant and then as assistant director of the institute. by that point in the aids epidemic, there were few emerging potential drugs, and there was a huge push to get as many people asñi possible in clinical trials for the new law -- for the new medication. every day, we were dealing with desperate people who wanted to live and have little hope. within a decade, fda had devised a pathway for companies to follow and also approved an entire new class of drugs to treat aids along with the answer retroviruses. -- and director viral --
antiretroviral. this gave me a deep appreciation of the scientific insights of research but also what scientists from companies, advocates, and the fda can do when working together. more recently, several partnerships in industry and universities are starting to bear fruit. one example concerns test for kidney toxicity. fda works with -- one example concerns test for kidney toxicity. fda works to identify biomarkers that could indicate kidney damage from a drug. this might signal the drug is toxic early in the development in the process before lots of time and money was spent developing the drug and bringing
it to clinical trials. as a result of this effort, fda now admits new data from seven different kidney toxicity. if we develop this, we could make additional progress for reducing the development time and cost of drug approval and hopefully provide more improved products for those who need them. similarly, we are working in partnership with others to try to develop better answers with shorter time frames, and by applying new knowledge in genomics, we hope to target in new ways that would be more meaningful for patients and health care system in the form of more advances and lower costs and time required to develop new drugs. .
it was established in a much simpler time. when it was created in 1938, only a tiny percentage of our goods were imported. now we import from more than 150 countries and 2004 and facilities, fda-regulated products. more than 20 million shipments of products are expected to arrive in the united states this
year. one decade ago, that number was about 6 million, and a decade before that, a much smaller fraction. the problem is growing rapidly and enormously. consider that 20% of the food that we eat comes from other countries, and 75% of the seafood come strong foreign waters -- comes from foreign waters. and fruits and vegetables are the most vulnerable to contamination. up to 80% of the act of pharmaceutical and agreements from drugs coming from foreign sources. the numbers are extraordinary. this represents a wealth of new products now available to americans, and many benefits,
yet creating a whole host of additional challenges. it is impossible to stop all bad goods at the border. we are responsible for monitoring the goods, and that represents an insignificant increase in the two decades ago, despite the fact that the volume of imports has been growing enormously. as a result, we inspect less than 1% of these products before they enter the united states. last week, and as the introduction of a new computer system helping fda investigators prioritize the way that they expect imports. the system allows us to prioritize inspections by risk level. this makes it easier to find problems. we cannot expect to solve every
import problem with men and women on the dock. we need a new paradigm for inspections that reaches back along the chain of productions to the countries sending us products and the factories and farms that produce the goods. the only way to do this is to take our global role -- perceive our global role as a shared responsibility. this means insuring they share responsibility and accountability and not rely on the fda to show up and find a problem in the plant. it means building up a worldwide network of oversight, working closely with international organizations and other national governments, harmonizing standards, helping to build regulatory pathways and other countries that have less short regulatory systems, and sharing the responsibility of inspection
and the information that comes from them. this is a supreme priority for the fda, and we are in the midst of many many ways of making it happen. we are setting up permanent offices around the world, signing more than 30 agreements to enable us to share information from inspections and other safety information with other countries that have much for regulatory systems like ours. we are training regulators in countries with less experience and helping them to build capacity. we're not only improving the safety of products coming to our shores but helping other countries may help the improvements in the goods being offered to their rooms citizens. this is a form of health diplomacy, and it makes sense and a globalized economy where we are all connected to each other. my first big job and public health was serving as the new york city health commissioner
for six years during the 1990's. during that time, mike two children were born and it made an impact on me. on my children's birth certificates, my name appeared twice, both as their mother and is the health commissioner. [laughter] both roles gave me a duty to protect them, at home and by preventing illness and promoting health for them and the world around them. the second role was not just a duty to my children but to all children and to everyone in that city. my job is different and the approach is different but the mission is the same -- protect the public health. it is the goal in all that we do. thank you for your attention and hopefully for your support. [applause]
i talked longer than planned but i think we still have time for some questions. [inaudible] >> what are to begin? -- why don't you begin? >> could you talk more about your responsibilities with regard to tobacco and how it compares with your authority at fda and what you are doing to carry it out? >> this is obviously a new mission for us today. it is a historic advance. i think it will make a huge difference in the ability to reduce smoking in this country and hopefully present the -- prevent the onset of youth smoking. it in many ways draws on
existing strategies for regulation, but in many ways it is also quite different and we are developing new approaches. the legislation was signed into law in the summer, last summer, by the president. it laid out a number of very explicit requirements for us in terms of actions we must take. we have meeting ford rapidly, setting up a center, recruiting a director, and hiring at the same time that we're implementing important programs. the law focuses on several key areas. one is increasing our understanding of the science of tobacco and tobacco products, understanding the components of tobacco products, which the companies are now required to
report to us, and then being able to address with much better information and specifics the health hazards contained therein. we also have explicit authority to reduce the onset of smoking, particularly in you, and to address strategies for getting people who are already smoking to quit. we have already moved forward into a candy and spice-flavored cigarettes, which is something that has been linked to enticing young smokers into taking up the habit. we are also moving forward with making more explicit warning labels or cigarette and tobacco products, and addressing issues
of advertising. we're working with regulators from other countries who are already engaged in some aspects of tobacco regulation in order to learn from them what we can. working closely with states and local authorities as well to implement aspects of this law. we have already been sued three times, which has not surprised does, but we are up and going, moving forward, and the fruits of some of our labor -- we have an ambitious agenda going forward. >> what do you think is the biggest single challenge there? >> it is such an important area. many ask the question at that
time of whether it was too big a challenge for fda to take on with all the other important tasks that it was already juggling. for me it is very appropriate for fda as a science-based, science-driven public authority. i cannot think of any other place that it can be. the legislation came with the source of funding which is very important. so we really feel very comfortable that we're getting the systems into place and the requirements of the law, as i said, are very explicit. so the great challenge is to hit the ground running, because we simply had no other choice if we were going to achieve the goals of the law, and i believe that
we're well on our way but it will obviously require continuing effort, lots of attention, a real dedication -- because what we're doing is not always well received, but what we are doing will make a difference for the help of our children. >> harkening back your comments that no good deed goes unpunished, and looking back at h1n1, obviously of vaccine was brought out in record time, really stunning. it was also, look at from another perspective, late, and if the virus was more deadly than it was, we would have a big problem on our hands. what learning does the fda take away from that experience? >> there are overall lessons to
be learned in terms of preparedness. one is that planning matters. had we not been investing in public health preparedness and pandemic foil for period of years, we would have been much more devastated when h1n1 emerged. ironically, i was working and leading the department of health and human services pandemic preparedness planning back in the clinton administration, but at that time we could barely get anyone outside of hhs to take threats seriously. when i approached the mock up about working with us in our planning efforts -- when i approached fema about working with us, they said, infectious disease? we do not do that. we do hurricanes and natural disasters. they did agree to do a table top exercise with us where we
unfolded a scenario and they quickly realized that this is a major disaster on a major scale. and they brought in others which have been engaged in pandemic preparedness and other biological threats. much more intensively and i think that that made a difference. it certainly underscores the importance of not becoming complacent. right now it is critical that just because h1n1 turned out not to be as severe a diseases we initially thought it might be, we cannot take comfort and think, well, a pandemic flu is not really the big problem there for one hype it up to be. now was time to look back at the significant lessons learned and put in place the changes to our system that will make it different, going forward.
and we need to invest in critical research to make us safer and more nimble in addressing the threat of the next flu pandemic or the next unknown. we do not have to be relying on an outmoded vaccine technology that even under the best of circumstances -- and we did produce this faxing which has proven to be very safe -- this vaccine which has proven to be very safe, we were still relying on a vaccine technology that reflected yesterday's science, not today's. we need to continue to invest in new diagnostics, new vaccine platforms, and new antiviral drugs, an fda plays a critical role in supporting that innovation and its translation
into real world product. >> i think we have another question over here. >> [inaudible] i would like to ask about a specific subset of that. in the area of clinical trials analytics, what is the fda thinking about comparative effectiveness research and population epidemiology, going forward? >> i think the whole way that we address clinical trials and our tools for analysis and our strategy is very key to enable us to read have almost effective and in addition regulatory pathway for new medical products. we're working hard in that area and i mention we have been working in partnerships to enhance our scientific standing to understand that work and
implement the new practices. we see population-based approaches has very key to strengthening our ability to monitor safety throughout the life cycle of a product. we are putting all lot more attention now on post-marketing surveillance strategies, pharmacological epidemiology approaches that will enable us to identify safety concerns once a drug is out in the marketplace, now being used by many more individuals than during the clinical trial process. we can use these population- based approaches in the post- marketing a reign of, also bringing in information technology to bear, so that we do data mining and access and often the first data base in an integrated way so that we can
identify and respond quickly to emerging safety issues. that is another important area, and i think very exciting work. research is very important to understanding -- deepening our understanding about the relative value of certain products and the roles of different products under different circumstances. fda's statutory responsibility is to review and approve or disapprove products that come before us, not so much in a directly comparative way. we do use comparative reformation in terms of -- information in terms of how we may recommend certain drugs. but there are many opportunities for fda to engage more deeply
with broader effort in comparative effectiveness research. we have actually received some resources through the stimulus moneys, to help us build that capacity. and it comes from opening up some of our data and resources said that people asking questions -- so that people asking questions in the comparative effectiveness research can use that important information to than deepen our understanding and ultimately to better serve the people who need access to the best possible drugs for their conditions. it is a very important area and there is a lot of work within the department going forward, and of course in the broader
world of health services research. >> next question over here, please. >> can you hear me? i was glad you mentioned by a markers. b --- biomarkers. i am concerned about the new drugs being developed with biomarkers. one lot was approved with african-americans in rolling in the clinical trials. it appears it is not at all effective in patients with african american ancestry. >> i think your question speech to the point that we need very much -- speaks to the point that we need very much to examine medical products in a range of different sub populations and recognize that there may be
different response both in terms of benefit and risk. i think that we learn more about those underlying mechanisms of disease and the potential role of genetic markers and biomarkers. we need to start to target therapies in new ways for the sub populations that will benefit. it is more demanding in terms of the research needed in some ways, but i think it obviously will bring huge benefits and it will help us better runner stand -- better understand both people and sub-populations that should not be receiving a given drug because we know that they may be more susceptible to risk. or it may not work for them.
but it will also enable us to not discard a potentially useful drugs for certain sub- populations because if you look at the broad numbers, there are risks that might jeopardize the use of the drug overall. there's an effort that has to go on looking at risk and benefits, depending on deepening our understanding of the science and how we use these emerging tools appropriately and making sure that we collect data from all of the appropriate populations inappropriate ways, and that we are examining the use of medical products for the whole life cycle of the product, from the time of initial discovery out
into the marketplace, and often some of the most important information can be gleaned in a timely way so that we can protect health and minimize risk. >> we want it thank you so much. we know that you have to get back. protect all 300 million abbas. we want a thank you for your comments. -- all 300 million of oz. we want to thank you for your comments. [applause] >> in a few moments, a discussion of climate change from world economic forum. in a little more than an hour, a look at the congressional agenda relating to this year's elections. and after that, former u.n. ambassador john bolten on the obama administration's foreign policy.
on "washington journal," john stanton will talk your -- take your questions about the job bill working its way to the senate. we will hear from mark moyar about the war in afghanistan. and richard norton smith discusses the updated version of his book, "who is buried in grant's tomb?" "washington journal" is live every morning at 7:00 a.m. hear on c-span. >> it is the only selection of american presidential portraits. it is now on display at duke university -- for purdue university. it looks at the lives of paintings, prints, and audio recordings. it is sponsored by c-span and the white house historical association. if you cannot get to it, look at
the entire collection on line at c-span.org. >> now what discussion on climate change from a recent world economic forum in switzerland. panelists include mexican president felipe a call the road and ed markey. this is a little more than an hour. >> thank you all very much for coming. my name is timothy wirth. i am president of united nations foundation and it is my privilege to help to moderate this very important panel. the topic today, and let me read from the agenda to remind us all, "the u.n. climate change conference in copenhagen did not lead to a definitive global solution on carbon emissions. what immediate steps should governments, businesses, and civil sought -- civil society take towards a long-term climate path that is both economically effective and economically
efficient?" this session is part of an ongoing effort by the world economic forum to help improve international cooperation by surfacing the base that -- the best ideas and triggering new practices in the governance of most important challenges. davos should serve as a thread for feedback on ideas and proposals that the global agenda councils are working at under the framework of redesign. as we talk about climate change, let me divert for just a minute for those of you who may not watch this all in great detail and just give you a little bit of definition so that some of the words that may be, or terms that may be unfamiliar, we can all share. first, the framework convention is the climate treaty. it is called a framework convention. it was negotiated in rio in 1992. the operative words were "avoid dangerous anthropogenic interference in the climate system." kyoto, which came five years
after the climate convention was ratified by 180 some-odd countries, so the united states was the sixth country to ratify the basic climate treaty. kyoto was the first implementation protocol to the treaty, that was 1997. it was at kyoto that a distinction was developed between specifically what the responsibilities of developed countries were going to be, the so-called and x 1 countries, and what developing countries, everybody else should do, the so-called non-aniks 1 countries. -- non-annex 1 countries. copenhagen was the third convening that occurred in december. it's additional purpose -- its initial purpose was to design a treaty in which nations all around the world could come together in agreement about what
a global strategy should be related to climate change. when you hear reference to cops, it has nothing to do with policemen. kopp means the conference of the parties. the conference of the parties are all the countries who ratified the treaty. they are members of the top. what happened in copenhagen was the 15th conference of the parties, the 15th year since the treaty was ratified in 1992, and mexico will be the host of the next crop this year in 2010, so president calderon has a very important function, and what we're talking about today is the time between and what we do between cop-15, copenhagen, and cop-16, which will occur in mexico. final definition -- the ipcc is the intergovernmental panel on climate change. that is the scientific group that came together in the late 1980's, sponsored by the un's
world meteorological organization in the world nation -- and the united nations environmental program. more than 2000 scientists from all over the world who have developed the consensus science upon which all of the climate negotiations have occurred. that is the ipcc. we're talking about the way forward, and that clearly will be led by president called rome. as we agreed this morning with his forbearance, we will spend a few minutes first on where we have been, what happened in copenhagen. if we did a cloud analysis of discussions at davos this week, i think that no doubt copenhagen would appear in very large, bold letters. while some have very strong views, so -- most people are still trying to figure out exactly what did happen in copenhagen and where we go from here, our topic this morning. this is by no means clear and
there is by no means a consensus. those with a very positive interpretation of copenhagen will most often cite the fact that leaders in copenhagen, going into copenhagen, had to learn their brief, nations developed consensus on the seriousness of this issue, and it was the first international meeting based on the international consensus science, despite efforts of the climate doubters and deniers to undermine the science, and despite some of unhappy and sloppy science and science writing. the evidence is incontrovertible that the globe is warming and that man is largely responsible. there was consensus on the target, that we should shoot to have no higher than 82 degrees centigrade increase or 450 parts per million of carbon in the atmosphere, and should move toward a low-carbon economy by 2050 and the developed and developing world both make
commitments, a breakthrough away from the stark line that had existed between and next one -- annex 1/non-annex 1 countries. that landed been very troublesome and and and is changing in very interesting ways. out of copenhagen, the developed countries agreed to a $10 billion package of assistance moving to a $100 bill it -- $100 billion package by the year 2050 -- 2020. that is the positive view and there are many positive elements of copenhagen. the negative is that there was total chaos in the negotiations and that venue really reflects the nap -- the lack of capacity of the un to undertake such
negotiations, would say the critics. no agreement was reached. there are greater divisions between north and south, and the urgency is much greater than negotiations would suggest, and we now have to find a new venue and a new approach. there is a very broad split and many shades of difference in between. to start the morning, we of basque -- we have asked yvo de boer, the executive secretary of the framework convention on climate change to set the scene as to what does he, from the perspective of the conference of the parties in the un, believe was the result of the copenhagen. we've been asked shyam saran, the former said foreign secretary of india and now special envoy of the prime minister for the india perspective about what happened, some very interesting and different negotiations occurred
in copenhagen. and then congressman ed markey, the co-author of the important waxman-markey legislation in the house, a longtime member of the congress, to respond from the perspective of the developed country -- the developed world as to what happened. we will then turn it over to president calderon who has the responsibility for guiding us into the next year of these negotiations for a more lengthy discussion. we will ask two industry people, carlos ghosn and caio koch-weser to talk about their perspective on and that steps, especially since the private sector is now playing a larger role, which was practically invisible in copenhagen, but now must be brought much more to the fore. then we allow the discussion among ourselves back and forth, then we will save the final 20 minutes for questions.
would like to begin by talking about what copenhagen was not. copenhagen did not deliver an agreement on a second target period under the kyoto protocol. copenhagen did not deliver an agreement under the nearly blinding instruments in the climate change convention. it did not deliver targets for individual and industrialized countries. it was not really supposed to do that. copenhagen is a step on a longer journey to come to that long term response. 15 conferences [unintelligible] more importantly is what copenhagen did do. what it did deliver is an incredibly important political statement. after the chaos we saw there was because 120 heads of state and government came to copenhagen.
and monitor and verify. basically, the architecturexd ws put in place. what i see flowing from that architecture our commitments at the national level. yesterday evening in my hotel room on my blackberry, i received a commitment of the united states about moving forward. china, india, brazil, mexico, south africa, korea -- a host of nations around the world are moving forward to address the issue of climate change, energy crises, security and in coherence -- moving in coherence with each other. what we need to do in moving forward toward mexico is to ensure that we put an international architecture in place, a regulatory framework that allows countries to move forward on the basis of a level playing field. in that sense, copenhagen will not have pleased the lawyers in the room. i think it has given an
important signal to the politicians and economists. >> in copenhagen of very important group came together. brazil, south africa, india, and china. shyam saran, would like to give us your perspective on what came out of that? >> thank you, mr. chairman. let me clarify that, as far as the four major developing countries, they were very clear in their minds that they would like to see a comprehensive, balanced, and equitable outcome on copenhagen. that outcome was not achieved. i believe one reason copenhagen did not live up to expectations of the international community was precisely because climate change has become enmeshed with
issues of economic interest and even political interests. it is extremely difficult to really focus attention on what all of us agree is one of the greatest global challenges humanity bases, but when we start working toward meeting that challenge, we get bogged down in a lot of issues of level playing field or competitiveness, issues which then make it very difficult for us to deliver the kind of collaborative response we need to climate change. >> i think what that developing countries were saying was that, in this case, we need collaboration. that is the spirit of collaboration which was missing. as far as we're concerned, what was good about copenhagen was that the major developed countries and the major in
developing countries did come together and reach a broad consensus. it was an important development in our journey toward a goal will -- global agreement. the fact that we reached some consensus leads us to believe that this could in fact become a very valuable input into the post-copenhagen negotiation process which will lead up to mexico city. this is where the countries have lost this is what the countries have stated. i disagree with the notion that the un system failed. it is not the multilateral -- even in multilateral conference, which have meetings and sideburns discussing various outstanding issues. what is very important is that we always bring that back to the multilateral group.
that is one reason copenhagen did not deliver. i think we should be very careful that we do not trashed the multilateral cultural when we take this forward. >> congressman markey. >> i think what happened in copenhagen -- from the perspective of the united states -- was that was a very significant step forward, not as far as we wanted to go, but it has put in place the requirement that all of the major players have to make a commitment and put it in writing. the united states yesterday put in writing their commitment to a 17% reduction by 2020 in
greenhouse gases. 80 -- 83% by 2015. that is a huge commitment. we had an election in massachusetts last week. the politics in the united states changed slightly, but the problems did not. president obama, in his state of the union address on wednesday night, made it very clear that he was fully committed to passing a comprehensive energy and climate legislation this year. we already completed that process in the house of representatives and the senate is now considering it. i think that if anyone had any doubts, the president removed those on wednesday night. yesterday, the united states made their commitment to the world. i think what happened in copenhagen with secretary
clinton announcing the united states intention to lead the effort to bring her -- to produce $100 billion a year to developing countries to help advance prevention efforts an adaptation efforts and transfer new energy technologies should remove all doubt that the united states is geared to be a leader and partnering with other countries in the world. the planet has a fever, there are no emergency rooms for planets. we have to act together to put in place the preventive measures that will assure that we do not see the most catastrophic consequences. the president call the wrong, it is over to you. people think there is direction in the right move -- >> president calderon, it is over
to you. people think there is direction in the right move. >> a lot you will be very welcome in cancun at the end of the year. one thing we need to do is try to learn from our mistakes in copenhagen and the previous part of that. one thing we need to do is reestablished trust and confidence between the parties. in order to do so, i want to hear all the voices, we want to bring to the table each and every country. we need to understand that there are very different perceptions of the problem, very different economic and political interests. there are legitimate interests. it is not the same -- the perception of all nations.
they could lose their territory -- it is not the same vision for developing countries. it is not the same vision of developed countries in europe and the united states. the idea is to hear everyone. the prime minister and other members we will be in very close contact with the specialized groups, the working groups working today in the different issues in post-kyoto protocol,
working on the issues that are established in a cop. of course, in return i will insist on good-faith negotiations. i want to avoid wasting our time and going home after cancun with empty hands, and in order to do so, we need to be very careful about the procedure. one of the points that we need to establish is what exactly are the consequences. copenhagen provided us with a very good basis, if i understand. the goals about related to the temperature, the commitment related to the fund, the green fund established there, and very important things. my perception is that the lack of consensus is related with the economic problems in each nation, because there are caught
-- economic costs associated with the task in order to tackle climate change. if we can find an economic mechanism with the right incentives in order to stimulate actions, coming out of developed or developing countries, we will be on track to find what we want to find in cancun -- a robust, comprehensive, and substantial agreement at cop 16. . there are a lot of troubles with negotiation by consensus, but we need to try it. before copenhagen, we started to organize some mutual meetings between some members of the community. each week, wednesday, several members -- many others, we have meetings through the internet.
maybe we can try to do the same. we can try to get informal gatherings through the internet periodically in order to speak about the problem and try to understand the main concerns. we will do our best, but let me be clear. i realize how important it is for the world to get success in cancun. it is important to start taking actions today. it is clear the scientific evidence is overwhelming. the effect of global warming are already erecting -- affecting ordinary people in developing and developed countries. there are more than 2000 tourists in peru that are stuck by mud -- in europe, something
is paralyzing the economic activity. a few years ago in france, thousands of people died because of high temperatures. we need to act now. mexico has a clear commitment in order to achieve these comprehensive, robust, and substantial agreements. >> mr. president, thank you. maybe the magic words are substantial agreement. we will come back and talk about how we did find that -- how we define that. another point that you made was that we must start taking action to date. carlos ghosn, one of the key variables in climate change car emissions from transportations. you have been at the center of transformation of that industry.
when you hear him say we have to start taking action today, what does that say to you? >> let me talk about the mexican commitment. mexico was the first developing country -- we were the first in developing countries to establish a unilateral, unconditional commitment to reduce 50 million tons a year starting in 2012. we are submitting our commitment in order to reduce 30% are emissions from business as usual by the year 2020 and 50% by the year 2015. in mexico, we are working to prevent deforestation. we are being very aggressive in terms of re-forestation.
we used to lose 300,000 acres per year. today, we are preventing deforestation and report stating -- read-for a single many -- re-foresting many acres per year. we're improving technology and trying to transform transportation and apply new mechanisms to massive waste of transportation in the cities. my point is that it is -- for the mexican economy, we suffered a recession almost 7%- last year. we are keeping our commitment. -- we suffered a recession almost 7% negative last year. the money will be there. it was a good step in copenhagen
to talk about our goals for 2020. how are we going to use that money? one principle must be this -- the result-based principle. we need to measure and be conspiring about our actions. carlos boehner, -- >> carlos ghosn. >> what do we need is the first question. we did the best we could in copenhagen. what we need for target. we need to move on. as a private sector, we need to know what the levels are we need to reach, where, and we need real targets. when we're talking about targets, is that 60%, 70%, 80%? after this, we need some
encouragement on process is like the president mentioned about an integrated approach prepare you cannot go to the car industry and say you do this, and go to another industry and said, you do this. in order to reduce emissions for cars, the best solution comes from cooperation through the industry's. -- industries. i ask for encouragement for an integrated approach. we want to target the best solutions that make the most sense and require the least resources. when you push for an integrated approach, you are pushing industry to have good representation. representation of the industry is a problem. we have been working towards one common position and we were not successful. recently, after three years of
work, we came with one statement which will be official today, signed by four ceos of the car industry, because most of them did not want to sign. we represent a substantial part of the car industry. if we do not push for an integrated approach, the public and governments will have some difficulty to understand what the technology is. at the end of the day, most solutions will come from innovation and from technology. the government's need to have an objective image about what it will allow you to do. we can use batteries for cars, five years ago it was not possible. what can we do in the next five years? we cannot expect the same things. somebody has to objectively explain what is possible and what is not. the final thing i would like to
mention is encouragement for private-public collaboration. i'm glad to see there is a specific example taking place in the united states and in europe or japan. the government and private sectors are coming together. the government and private sector cannot do it alone we have to -- cannot do it alone. we have to do it together. we have to be very efficient. >> thank you. that leads us into file processor -- caoi koch-weser. -- caio koch-weser. we have talked about a large pools of capital that are necessary for mitigation an adaptation in the climate area, promises made from the developed world to develop -- to the developing world. a clearly cannot come from the public sector. give us your view.
you thought long and hard about the vehicles that may be necessary and possible. >> from a private sector perspective, i would call the result of copenhagen the glass half full. we did not have high expectations before. on the positive side, all sectors -- so to speak, the group of countries committed to action is expanded. the basic countries are very important element in that. we have that outline of what could be a future financing mechanism. the hundred billion dollars of which comes out of budgets which will be required for mitigation an adaptation action is in there, the details will be worked out. the private sector will have to finance a lot of that.
an anti-to add to the list is that we have uncertainty -- an immediate negative to add to the list is that we have some doubt and uncertainty about how to go forward. where do we go from here? we need to create momentum with a three-pronged approach for strategy, one being the u.n. strategy. i hope there will be progress. it will be tough, but important. it will have to be run very differently. there are a lot of lessons to learn. the second prong of the strategy becomes very interesting. it would be to have a smaller groups of like-minded countries come together a ground certain sectors and issues and push the
agenda forward. there are good examples of how some countries to the lead with money on the table. there is transparency. i could see this happen in other sectors from a business point of view. perhaps in a tradeable sector. international shipping, transport, steel. power. again, put serious money on the table. ab credible performance. -- have credible performance. such architecture, small acquisitions -- it can push the second prong forward which would reinforce and lead back into the first prong, which is the u.n. process. i would not -- there is evidence, even within the u.s., that of national entities --
that sub-national entities could come together and formed these small coalitions to move on certain agenda items. the third prong is leadership from the private sector to identify this as a major opportunity, not a burden. opportunities for future growth and innovation, led with big projects. we are involved in many of these. we have big ambition of bringing 15% of the electorate did -- electricity requirements of europe from solar power. these are transformational projects. the technology exists. financing will be difficult, but it is doable. then comes the government and private sector are rounded these new innovative projects to create the framework conditions.
here comes the public-private partnership. it works in a way that can lead to success which would scale up and leverage up limited amounts of public money. for example, taking equity positions on certain projects that then leverage is in the private. the $100 billion will have to come from cap and trade. it will come from scenes like this of leveraging up public- private monies and guarantees. ando have provided some. that would make my three-pronged strategy. this is independent, these prongs from eachk but mutually reinforcing in the end.